I would say the MD order for an LC consult should be only for the IBCLC.
The Counselor can float from room to room talking, schmoozing, tweaking
latches, offering help and information, and referring any newly discovered
complicated problems to the IBCLC. This way, you improve the chances that
all moms are seen, possibly even those who are "bottle-only" by personal
choice. It can help find situations where mom didn't know she had a problem
and didn't know what questions to ask. The BF counselor is the one the RNs
can grab by the sleeve in the hall with that panicky look on her face,
"She's got a bottle in her hand. Go there quick! before baby gets formula!"
(Yeah, well, some do, some don't. So why was there formula in the crib
drawer anyway?)

The BF counselor is a triage person but NOT equally interchangeable with
the IBCLC. I trust she has attended at least one formal training program in
Basic BFing. Under the guidance of the IBCLCs, she can earn her clinical
credits to sit the exam herself as she grows into handling more complicated
situations.

But when the nurse manager implies that there is no difference because the
docs don't perceive a difference, she belittles your credential. Would she
react the same way if you said, "RN, LPN, PCA, what's the diff as long as
someone sees mom? To the general public, all females in scrubs are nurses,
right?" Time for hospital-wide education on the differences between
credentials, education, clinical practice, and course certificates.

Phyllis




> Hello!
>
> The hospital I am employed by has IBCLC'S as well as non-
> certified "counselors" who assist us with daily rounds.
>
> I am aware that "Lactation Consultant" is not a title that only IBCLC's
can
> use.  However, I believe that the general public, as well as our
> physicians, use the terms "LC" and "IBCLC" interchangeably.
>
> My dilemma is this:  When an MD orders a "Lactation Consult", I feel it
> should be done by an IBCLC.  My manager doesn't feel this way.  She is of
> the mindset that "The MD's don't know and don't care who does the consult,
> as long as it gets done.  And, we have never told them that every consult
> would be done by an IBCLC."
>
> Lactation Consults are typically written for problems only.
>
> My question is this:
>    Ethically, can/should a NON-IBCLC meet with a patient for a "Lactation
> Consult".
>
> Thank you for your help in clarifying this.
>
> Janet Kercher RN, IBCLC
> Elkhart, IN
>


--- Phyllis Adamson, IBCLC, RLC
--- Glendale, AZ, USA
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